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Caregivers get training that simulates sensory and memory losses of dementia

By Leslie Tamura
Tuesday, July 6, 2010; HE06

Put on a necktie. Buckle a belt. Write the names of my family members. And . . . what? I had five things to do in five minutes, but I couldn't seem to remember what they were.

This was largely because I couldn't feel, see or move as I usually do. I'd been gloved, goggled, headphoned and otherwise handicapped in an attempt to make me feel like an elderly person whose body and mind have begun to fail.

When I couldn't remember my tasks, I was nervous and embarrassed. I looked around, second-guessed myself. Seeing a pile of laundry, I started folding -- but was that one of my tasks?

Is this what it feels like to have dementia?

"That was frustrating," said one of my classmates, Carolyn Young, 58, after she emerged from the simulation. "I didn't understand the directions. . . . I was on my own, and I didn't know what to do."

That's the idea. Along with 35 employees and associates of the Sunrise Senior Living Community in McLean, I was taking a class for caregivers that its creator calls VDT -- the Virtual Dementia Tour. The idea is to simulate memory loss and sensory inhibition, then challenge the student with everyday jobs.

As the class began, my hands were put in plastic gloves filled with unpopped popcorn kernels, dulling my fingers' ability to feel. Taping together the thumb and forefinger of my dominant hand and binding three fingers of my other hand restricted movement and fine motor skills. In other words, staff members told me, this is how it feels to have arthritis.

They gave me goggles that limited my peripheral vision, with lenses tinted yellow to mimic the fading color vision of an aging retina. A black dot in the center of each lens made it difficult to see things directly in front of me, as if I had macular degeneration.

More corn kernels placed in my shoes simulated the foot pain associated with poor circulation, neuropathy and arthritis. Headphones on my ears played a mash of unclear sounds: radio chatter, background noises, the intermittent blare of an ambulance siren. The recordings were mixed to simulate hearing loss and to increase participants' confusion, VDT creator P.K. Beville had told me in a telephone interview: "They can't weed out the relevant and irrelevant stimuli."

Then I was sent to the unfamiliar territory of a typical Sunrise residential room to complete my five tasks.

According to the kindly staff, I did "very well." I put the tie around my neck. I buckled the belt. I wrote down the names of my family. But I don't think I was supposed to fold laundry. I think I needed to actually tie the tie. I had been directed to find a belt and loop it through some pants, not around my waist. My family members' names were barely relevant because, it seems, I was supposed to write a letter to them instead.

At least I didn't get angry. According to Beville, people with middle-stage dementia have lost skills but still have a sense of purpose, so they're easily upset. "They want to complete things," she said. "They're not sure how to complete them, and they're agitated easily."

VDT participants have the same response. Beville said she has seen some so frustrated they've thrown objects or so resigned they've simply quit. Some set a dinner table with socks when they couldn't find napkins. Others, told to put on a white sweater, couldn't find one and put a white bath towel around their shoulders instead.

"If normal people are exhibiting these behaviors," Beville said, "then watching Mrs. Jones with middle-stage Alzheimer's saying that she's cold and wrapping a towel around her doesn't mean she's exhibiting bizarre behavior. It's a coping mechanism."

Beville, who first studied the relationship of caregivers to aging patients in the 1980s as a postgraduate in clinical psychology, has been selling VDT kits since 2003. Sunrise has purchased 50 for many of its facilities in the Southeast. Next month, Sunrise communities in Northern Virginia will host VDT demonstrations for people caring at home for relatives with dementia.

Who knows how effective this training is? After I took it, I felt a little silly -- though on reflection, it made me consider how hard life must be for someone my grandmother's age.

After her tour, Young -- an adviser with A Place for Mom, an online referral service -- said she thought VDT would be a "great tool to use with families." When children are struggling to help an aging parent, she said, "it puts their minds at ease with what they've been dealing with."

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